All fields begining with an
(asterisk) are required and must be completed prior to hitting the Pay Now button.

Payment Sources

As part of Advanced Home Care’s continuing effort to streamline the patient experience,
Advanced Home Care now accepts online payments from Discover, MasterCard, Visa &
American Express.

Need Help?

If you need help with this form, please call 1 (800) 255-2321 and
select option #1 or email
ahcpaymentcenter@advhomecare.org. An Advanced Home Care representative will
be happy to assist you, and is available Monday — Friday
9:00am — 5:00pm.

Security

Advanced Home Care takes your security to heart. We have been verified by Authorized.Net and secured by GeoTrust.

By checking "I Agree," I authorize Advanced Home Care to charge my credit card for any balance owed that is my responsibility after insurance receives the claim* and to email prior notifications and receipts to XcardEmailX after each charge.

If you have any questions, please contact us at 1-800-255-2321.

*Please note - If Advanced Home Care cannot charge the card, the patient will be billed for the outstanding balance.